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首页> 外文期刊>BMC Emergency Medicine >The utility of the rapid emergency medicine score (REMS) compared with SIRS, qSOFA and NEWS for Predicting in-hospital Mortality among Patients with suspicion of Sepsis in an emergency department
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The utility of the rapid emergency medicine score (REMS) compared with SIRS, qSOFA and NEWS for Predicting in-hospital Mortality among Patients with suspicion of Sepsis in an emergency department

机译：快速应急医学评分（REMS）的效用与先生，QSOFA和预测患者在急诊部门脓毒症患者中的住院死亡率的新闻

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Many early warning scores (EWSs) have been validated to prognosticate adverse outcomes secondary to sepsis in the Emergency Department (ED). These EWSs include the Systemic Inflammatory Response Syndrome criteria (SIRS), the quick Sequential Organ Failure Assessment (qSOFA) and the National Early Warning Score (NEWS). However, the Rapid Emergency Medicine Score (REMS) has never been validated for this purpose. We aimed to assess and compare the prognostic utility of REMS with that of SIRS, qSOFA and NEWS for predicting mortality in patients with suspicion of sepsis in the ED. We conducted a retrospective study at the ED of Siriraj Hospital Mahidol University, Thailand. Adult patients suspected of having sepsis in the ED between August 2018 and July 2019 were included. Their EWSs were calculated. The primary outcome was all-cause in-hospital mortality. The secondary outcome was 7-day mortality. A total of 1622 patients were included in the study; 457 (28.2%) died at hospital discharge. REMS yielded the highest discrimination capacity for in-hospital mortality (the area under the receiver operator characteristics curves (AUROC) 0.62 (95% confidence interval (CI) 0.59, 0.65)), which was significantly higher than qSOFA (AUROC 0.58 (95%CI 0.55, 0.60); p?=?0.005) and SIRS (AUROC 0.52 (95%CI 0.49, 0.55); p??0.001) but not significantly superior to NEWS (AUROC 0.61 (95%CI 0.58, 0.64); p?=?0.27). REMS was the best EWS in terms of calibration and association with the outcome. It could also provide the highest net benefit from the decision curve analysis. Comparison of EWSs plus baseline risk model showed similar results. REMS also performed better than other EWSs for 7-day mortality. REMS was an early warning score with higher accuracy than sepsis-related scores (qSOFA and SIRS), similar to NEWS, and had the highest utility in terms of net benefit compared to SIRS, qSOFA and NEWS in predicting in-hospital mortality in patients presenting to the ED with suspected sepsis.
机译：许多预警评分（EWSS）已被验证，以预后在急诊部（ED）中进行脓毒症的不良结果。这些EWS包括全身炎症反应综合征标准（SIRS），快速顺序器官失败评估（QSOFA）和国家预警分数（新闻）。然而，为了此目的，从未验证过急的紧急医学评分（REM）。我们的旨在评估和比较REMS的预后效用，并与先生，QSOFA和新闻预测患者怀疑ED脓毒症的死亡率。我们在泰国锡拉德尔大学锡拉迪尔大学埃德进行了回顾性研究。包括涉嫌在2018年8月至2019年7月至7月期间患有败血症的成年患者。他们的EWSS被计算出来了。主要结果是均导致的住院死亡率。二次结果是7天死亡率。该研究中共有1622名患者; 457（28.2％）在医院出院死亡。 REMS产生了歧视性的内部死亡率最高（接收器操作员特性下的面积曲线（Auroc）0.62（95％置信区间（CI）0.59,0.65）），其显着高于QSOFA（Auroc 0.58（95％） CI 0.55,0.60）; p？= 0.005）和SIRs（AuroC 0.52（95％C 10.49,0.55）;p≤≤0.001），但不显着优于新闻（AuroC 0.61（95％Ci 0.58,0.64） ; p？= 0.27）。 REMS是校准和与结果相关的最佳EWS。它还可以提供决策曲线分析的最高净利益。 EWSS加上基线风险模型的比较显示出类似的结果。 REMS也比其他7天死亡率更好地表现优于其他EWS。 REMS是一种早期预警成绩，比败血症相关的分数（QSOFA和SIRS）更高，类似于新闻，与先生，QSOFA和预测患者中医院死亡率的新闻相比，净利润的效用最高与疑似败血症的ed。

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